中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2015年
13期
119-122
,共4页
杨大富%梁华良%陆荣森%黄芳伟%梁多%黄伙
楊大富%樑華良%陸榮森%黃芳偉%樑多%黃夥
양대부%량화량%륙영삼%황방위%량다%황화
前列腺增生%膀胱结石%经尿道前列腺等离子剜除术%膀胱切开取石
前列腺增生%膀胱結石%經尿道前列腺等離子剜除術%膀胱切開取石
전렬선증생%방광결석%경뇨도전렬선등리자완제술%방광절개취석
Hyperplasia of prostate%Bladder stone%Transurethral plasma kinetic enucleation of prostate%Bladder lithotomy
目的：探讨经尿道前列腺等离子剜除（TUPKEP）联合膀胱切开取石治疗前列腺增生合并膀胱多发（大）结石的疗效。方法：回顾性分析46例在本院行经尿道前列腺等离子剜除术联合膀胱切开取石治疗前列腺增生合并膀胱多发（大）结石病例的临床资料。结果：46例均同期一次手术成功，取石成功率100％。手术时间60~155 min，平均（90.54±19.75）min；出血量50~300 mL，平均（150.42±55.46）mL；术后住院时间7~9 d，平均（7.53±0.68）d。全部患者无手术死亡，无术中、术后大出血，无输血，无膀胱穿孔、前列腺电切综合征（TURS）、尿瘘、切口感染等并发症发生。术后随访6~24个月，平均（16.76±5.11）个月， IPSS、QOL、PVR均较术前明显改善，比较差异有统计学意义（P<0.05），其中IPSS由术前平均（26.48±2.54）分降至（5.63±1.22）分，QOL由术前平均（4.63±1.12）分下降至（1.23±0.94）分，PVR由术前平均（208.38±35.53）mL下降至（13.52±3.47）mL。且全部排尿通畅，无真性尿失禁、膀胱结石复发及尿道狭窄发生。结论：同期行TUPKEP联合膀胱切开取石治疗前列腺增生合并膀胱多发（大）结石具有安全、方法简单、创伤小、效果好等优点，尤其适合于前列腺体积较大、合并膀胱多发大结石及合并基础病的高龄高危患者，疗效肯定，安全性高，值得推广。
目的：探討經尿道前列腺等離子剜除（TUPKEP）聯閤膀胱切開取石治療前列腺增生閤併膀胱多髮（大）結石的療效。方法：迴顧性分析46例在本院行經尿道前列腺等離子剜除術聯閤膀胱切開取石治療前列腺增生閤併膀胱多髮（大）結石病例的臨床資料。結果：46例均同期一次手術成功，取石成功率100％。手術時間60~155 min，平均（90.54±19.75）min；齣血量50~300 mL，平均（150.42±55.46）mL；術後住院時間7~9 d，平均（7.53±0.68）d。全部患者無手術死亡，無術中、術後大齣血，無輸血，無膀胱穿孔、前列腺電切綜閤徵（TURS）、尿瘺、切口感染等併髮癥髮生。術後隨訪6~24箇月，平均（16.76±5.11）箇月， IPSS、QOL、PVR均較術前明顯改善，比較差異有統計學意義（P<0.05），其中IPSS由術前平均（26.48±2.54）分降至（5.63±1.22）分，QOL由術前平均（4.63±1.12）分下降至（1.23±0.94）分，PVR由術前平均（208.38±35.53）mL下降至（13.52±3.47）mL。且全部排尿通暢，無真性尿失禁、膀胱結石複髮及尿道狹窄髮生。結論：同期行TUPKEP聯閤膀胱切開取石治療前列腺增生閤併膀胱多髮（大）結石具有安全、方法簡單、創傷小、效果好等優點，尤其適閤于前列腺體積較大、閤併膀胱多髮大結石及閤併基礎病的高齡高危患者，療效肯定，安全性高，值得推廣。
목적：탐토경뇨도전렬선등리자완제（TUPKEP）연합방광절개취석치료전렬선증생합병방광다발（대）결석적료효。방법：회고성분석46례재본원행경뇨도전렬선등리자완제술연합방광절개취석치료전렬선증생합병방광다발（대）결석병례적림상자료。결과：46례균동기일차수술성공，취석성공솔100％。수술시간60~155 min，평균（90.54±19.75）min；출혈량50~300 mL，평균（150.42±55.46）mL；술후주원시간7~9 d，평균（7.53±0.68）d。전부환자무수술사망，무술중、술후대출혈，무수혈，무방광천공、전렬선전절종합정（TURS）、뇨루、절구감염등병발증발생。술후수방6~24개월，평균（16.76±5.11）개월， IPSS、QOL、PVR균교술전명현개선，비교차이유통계학의의（P<0.05），기중IPSS유술전평균（26.48±2.54）분강지（5.63±1.22）분，QOL유술전평균（4.63±1.12）분하강지（1.23±0.94）분，PVR유술전평균（208.38±35.53）mL하강지（13.52±3.47）mL。차전부배뇨통창，무진성뇨실금、방광결석복발급뇨도협착발생。결론：동기행TUPKEP연합방광절개취석치료전렬선증생합병방광다발（대）결석구유안전、방법간단、창상소、효과호등우점，우기괄합우전렬선체적교대、합병방광다발대결석급합병기출병적고령고위환자，료효긍정，안전성고，치득추엄。
Objective:To discuss the curative effect of the operation which TUPKEP combined with bladder lithotomy for prostatic hyperplasia with bladder multiple calculi(large). Method:The operation clinical data which TUPKEP combined with bladder lithotomy for prostatic hyperplasia with bladder multiple calculi(large)of 46 cases were reviewed. Result:There were 46 cases of the operation which TUPKEP combined with bladder lithotomy for prostatic hyperplasia with bladder multiple calculi(large)were successful simultaneous therapy,the success rate of lithotomy was 100%. Operation time was 60-155 min,average(90.54±19.75)min. The bleeding was 50-300 mL,average (150.42±55.46)mL. The patients were in hospital 7-9 days,average(7.53±0.68)days after operation. No patient dead in operation or hemorrhage or blood transfusion or bladder perforation or(TURS)or urinary fistula or infection of incision complications. The time follow-up was 6-24 months,average(16.76±5.11)months,IPSS,QOL,PVR was improved before operation,a statistically significant difference(P<0.05),IPSS from preoperative average(26.48±2.54) points to(5.63±1.22)points,QOL from preoperative average(4.63±1.12)points to(1.23±0.94)points,PVR from preoperative average(208.38±35.53)mL to(13.52±3.47)mL. All patients were urinate unobstructed with no really urinate incontinence or no bladder calculi recurrence or urethral stricture. Conclusion:TUPKEP combined with bladder lithotomy for benign prostatic hyperplasia with bladder multiple calculi(large)simultaneous therapy is safety and simple method with good effect and little trauma,especially fit for the patients which aged high-risk with larger bladder prostate and multiple stones and other basis of disease.
